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1.
Int. j. morphol ; 41(6): 1751-1757, dic. 2023. ilus, tab
Article in English | LILACS | ID: biblio-1528791

ABSTRACT

SUMMARY: To observe the effect of sevoflurane combined with brachial plexus block (BPB) in children with humeral fracture surgery and its effect on hemodynamics. 84 children who received surgical treatment of humeral fracture in our hospital from September 2019 to September 2022 were selected. According to different anesthesia methods, the children were divided into control group and study group. The control group only received laryngeal mask sevoflurane; the study group received laryngeal mask sevoflurane combined with BPB. The operation situation, hemodynamic indexes, stress level, pain and adverse reactions of children was observed. The postoperative awakening time in the study group was lower than control group, the postoperative pain onset time in the study group was higher than control group (P0.05). Postoperative 2h, the levels of serum cortisol, b-endorpin, norepinephrine and epinephrine in the study group were lower than control group (P0.05). Sevoflurane combined with BPB is helpful to shorten the postoperative awakening time of children with humeral fracture, reduce the degree of postoperative pain, improve hemodynamics, and reduce stress response, and has good safety.


El objetivo fue observar el efecto del sevoflurano combinado con bloqueo del plexo braquial (BPB) en niños con cirugía de fractura de húmero y su efecto sobre la hemodinámica. Se seleccionaron 84 niños que recibieron tratamiento quirúrgico de fractura de húmero en nuestro hospital desde septiembre de 2019 hasta septiembre de 2022. Según diferentes métodos de anestesia, los niños se dividieron en grupo control y grupo de estudio. El grupo control solo recibió sevoflurano en mascarilla laríngea; el grupo de estudio recibió sevoflurano con mascarilla laríngea combinado con BPB. Se observó la situación operatoria, índices hemodinámicos, nivel de estrés, dolor y reacciones adversas de los niños. El tiempo hasta el despertar postoperatorio en el grupo de estudio fue menor que el del grupo control, el tiempo de aparición del dolor postoperatorio en el grupo de estudio fue mayor que el del grupo control (P0,05). A las 2 horas postoperatorias, los niveles séricos de cortisol, β-endorfina, norepinefrina y epinefrina en el grupo de estudio fueron más bajos que los del grupo control (P 0,05). El sevoflurano combinado con BPB es útil para acortar el tiempo de despertar del posoperatorio de los niños con fractura de húmero, reduce el grado de dolor postoperatorio, mejora la hemodinámica y reduce la respuesta al estrés, además de tener buena seguridad.


Subject(s)
Humans , Male , Female , Child , Brachial Plexus Block , Sevoflurane/administration & dosage , Humeral Fractures/surgery , Anesthetics, Inhalation , Hemodynamics/drug effects
2.
Rev. bras. ortop ; 58(2): 265-270, Mar.-Apr. 2023. tab, graf
Article in English | LILACS | ID: biblio-1449785

ABSTRACT

Abstract Objective To evaluate the postoperative functional and radiographic outcomes of the shoulder of patients submitted to transosseous suturing of a greater tuberosity fracture (GTF) through an anterolateral route and the influence of the glenohumeral dislocation on these outcomes. Methods We conducted a retrospective study and functional assessment using the Constant-Murley score. The distance between the greater tuberosity and the joint surface of the proximal humerus (in true anteroposterior radiographs) after the union was calculated. We used the Fisher exact test for the categorical independent variables, and the Student t or Mann-Whitney test for the non-categorical variables. Results In total, 26 patients met the inclusion criteria, and 38% of the sample presented an association between glenohumeral dislocation and GTF. The mean Constant-Murley score was of 82.5 + 8.02 points. The presence of an associated dislocation did not alter the functional outcome. The mean distance between the greater tuberosity of the humerus and the joint surface of the humeral head after the union was of 9 + 4.3 mm below the articular line of the humeral head. The dislocation led to a lower level of reduction, but this did not influence the Constant-Murley score. Conclusion The cases of GTF submitted to surgical treatment with transosseous sutures had good functional outcomes. The presence of dislocation made the anatomical reduction of the greater tuberosity difficult. However, it did not influence the Constant-Murley score.


Resumo Objetivo Avaliar os resultados funcional e radiográfico pós-operatórios do ombro, em pacientes submetidos a sutura transóssea de fratura da tuberosidade maior (FTM) por acesso anterolateral, e a influência da luxação glenoumeral nesses resultados. Métodos Realizou-se estudo retrospectivo e avaliação funcional (pela escala de Constant-Murley). Calculou-se a distância entre a tuberosidade maior e a superfície articular do úmero proximal (por meio de radiografia em incidência anteroposterior verdadeira) após a consolidação. Usou-se o teste Exato de Fisher para as variáveis independentes categóricas, e os testes tde Student ou de Mann-Whitney para as não categóricas. Resultados Ao todo, 26 pacientes preencheram os critérios de inclusão. A associação de luxação glenoumeral com FTM foi observada em 38% da amostra. A média da pontuação na escala de Constant-Murley foi de 82,5 + 8,02. A presença de luxação associada não alterou o resultado funcional. A distância média da consolidação da tuberosidade maior do úmero em relação à superfície articular da cabeça umeral foi de 9 + 4,3 mm abaixo da linha articular da cabeça umeral. Pacientes com luxação associada evoluíram com redução menor, mas isso não influenciou na pontuação na escala de Constant-Murley. Conclusão As FTMs submetidas ao tratamento cirúrgico com sutura transóssea evoluíram com bom resultado funcional. A presença de luxação dificultou a redução anatômica da tuberosidade maior. Entretanto, isso não influenciou na pontuação na escala de Constant-Murley.


Subject(s)
Humans , Shoulder Dislocation/surgery , Suture Techniques , Suture Anchors , Humeral Fractures/surgery
3.
Rev. bras. ortop ; 58(1): 149-156, Jan.-Feb. 2023. tab, graf
Article in English | LILACS | ID: biblio-1441334

ABSTRACT

Abstract Objective To compare the use of cannulated screws and smooth Kirschner wires in terms of reducing the presence of exuberant callus and complications in pediatric displaced fractures of the lateral humeral condyle. Methods An analytical cross-sectional study of consecutive cases was conducted from May to October 2021 with 30 children with displaced external humeral condyle fractures. The functional results regarding pain and range of motion were stratified using the Dhillon grading system. Results A total of 19 patients underwent Kirschner wire fixation, and 11 underwent cannulated screw fixation. Closed fixation was performed in 14 cases (47%), and open fixation, in 16 (53%). Of the cases included, there was no loss to follow-up. Te sample was composed of 21 (70%) male patients, and the age ranged from 5 to 15 years, with a mean of 6.96 years. The most frequent cause of fracture was fall from height (50%), which was related to greater displacement on baseline radiographs. Complications that were not related to the reduction approach or the implant used were observed in 12 (40%) cases. Conclusion The present study shows no benefits in relation to the use of smooth pins or cannulated screws to reduce the presence of exuberant callus in the consolidation of the fracture. We see that the complications that arise are related to the severity of the injury, and benefits cannot be identified in the choice of one implant over another. We could see that the Weiss classification helps to define the behavior in favor of open or closed reduction without interfering in kindness of the smooth pin or the cannulated screw for fracture fixation.


Resumo Objetivo Comparar o uso de parafusos canulados e de fios de Kirschner lisos em termos da redução da presença de calo exuberante e de complicações em fraturas pediátricas deslocadas do côndilo lateral do úmero. Métodos Um estudo analítico transversal de casos consecutivos foi realizado de maio a outubro de 2021 com 30 crianças com fraturas deslocadas de côndilo umeral externo. Os resultados funcionais para dor e amplitude de movimento foram estratificados utilizando o sistema de classificação Dhillon. Resultados Ao todo, 19 pacientes foram submetidos à fixação de fio Kirschner, e 11 à fixação de parafusos canulados. A fixação realizada foi fechada em 14 casos (47%) e aberta em 16 (53%). Dos casos incluídos, não houve perda no acompanhamento. A amostra continha 21 (70%) pacientes do sexo masculino, e a idade variou de 5 a 15 anos, com média de 6,96 anos. A causa mais frequente de fratura foi queda de altura (50%), e esteve relacionada ao maior deslocamento nas radiografias da linha de base. Complicações que não estavam relacionadas à abordagem de redução ou ao implante utilizado foram observadas em 12 (40%) casos. Conclusão Este estudo não mostra benefícios em relação ao uso de pinos lisos ou de parafusos canulados para reduzir a presença de calo exuberante na consolidação da fratura. Vemos que as complicações que surgem estão relacionadas à gravidade da lesão, e não é possível identificar benefícios na escolha de um implante ou outro. Pudemos ver que a classificação de Weiss ajuda a definir o comportamento em favor da redução aberta ou fechada sem dar preferência ao pino liso ou ao parafuso canulado para a fixação da fratura.


Subject(s)
Humans , Child , Adolescent , Bone Screws , Bone Wires , Elbow Injuries , Humeral Fractures/surgery
4.
Chinese Journal of Reparative and Reconstructive Surgery ; (12): 566-571, 2023.
Article in Chinese | WPRIM | ID: wpr-981633

ABSTRACT

OBJECTIVE@#To investigate the short-term effectiveness of transverse antecubital incision in the treatment of failed closed reduction of Gartland type Ⅲ supracondylar humeral fractures (SHFs) in children.@*METHODS@#Between July 2020 and April 2022, 20 children with Gartland type Ⅲ SHFs who failed in closed reduction were treated with internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision. There were 9 boys and 11 girls with an average age of 3.1 years (range, 1.1-6.0 years). The causes of injuries were fall in 12 cases and fall from height in 8 cases. The time from admission to operation ranged from 7 to 18 hours, with an average of 12.4 hours. The healing of the incision and the occurrence of complications such as nerve injury and cubitus varus were observed after operation; the elbow flexion and extension range of motion after removing the gypsum, after removing the Kirschner wire, and at last follow-up were recorded and compared, as well as the elbow flexion and extension and forearm rotation range of motion at last follow-up between healthy and affected sides; the Baumann angle was measured on the X-ray film, and the fracture healing was observed. At last follow-up, the effectiveness was evaluated according to the Flynn elbow function evaluation criteria.@*RESULTS@#All incisions healed by first intention, and there was no skin necrosis, scar contracture, ulnar nerve injury, and cubitus varus. Postoperative pain occurred in the radial-dorsal thumb in 2 cases. The gypsum was removed and elbow flexion and extension exercises were started at 2-4 weeks (mean, 2.7 weeks) after operation, and the Kirschner wire was removed at 4-5 weeks (mean, 4.3 weeks). All the 20 patients were followed up 6-16 months, with an average of 12.4 months. The fracture healing time was 4-5 weeks, with an average of 4.5 weeks, and there was no complication such as delayed healing and myositis ossificans. The flexion and extension range of motion of the elbow joint gradually improved after operation, and there were significant differences between the time after removing the gypsum, after removing the Kirschner wire, and at last follow-up ( P<0.017). There was no significant difference in the flexion and extension of the elbow joint and the forearm rotation range of motion between the healthy and affected sides at last follow-up ( P>0.05). There was no significant difference in Baumann angle between the time of immediate after operation, after removing the Kirschner wire, and at last follow-up ( P>0.05). According to Flynn elbow function evaluation standard, 16 cases were excellent and 4 cases were good, the excellent and good rate was 100%.@*CONCLUSION@#The treatment of Gartland type Ⅲ SHFs in children with failed closed reduction by internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision has the advantages of complete soft tissue hinge behind the fracture for easy reduction and wire fixation, small incision, less complications, fast fracture healing, early functional recovery, reliable reduction and fixation, and can obtain satisfactory results.


Subject(s)
Male , Female , Humans , Child , Child, Preschool , Calcium Sulfate , Humerus , Humeral Fractures/surgery , Plastic Surgery Procedures , Fracture Fixation, Internal/methods , Bone Wires , Fracture Healing , Treatment Outcome , Range of Motion, Articular
5.
Chinese Journal of Traumatology ; (6): 94-100, 2023.
Article in English | WPRIM | ID: wpr-970980

ABSTRACT

PURPOSE@#Unsatisfactory results of hemiarthroplasty in Neer's 3- and 4-part proximal humerus fractures in elderly, have led to the shift towards reverse shoulder arthroplasty (RSA). The objective of our study was to repair the tuberosities that are generally overlooked during RSA and observe its impact on the functional outcome and shoulder scores.@*METHODS@#We include elderly patients with acutely displaced or dislocated 3- or 4-part proximal humerus fractures from July 2013 to November 2019 who were treated with RSA along with tuberosity repair by non-absorbable sutures and bone grafting harvested from the humeral head. Open injuries and cases with neuro-muscular involvement of the deltoid muscle were excluded. According to the tuberosity healing on radiographs of the shoulder at 9th postoperative month, the patients were divided into 2 groups, as the group with successful tuberosity repair and the other with failed tuberosity repair. Statistical analysis of the functional outcome and shoulder scores between the 2 groups were done by independent t-test for normally distributed parameters and Mann-Whitney test for the parameters, where data was not normally distributed.@*RESULTS@#Of 41 patients, tuberosity healing was achieved in 28 (68.3%) and failed in 13 (31.7%) cases. Lysis of the tuberosity occurred in 5 patients, tuberosity displacement in 2, and nonunion in 2. Mean age was 70.4 years (range 65 - 79 years) and mean follow-up was 58.7 months (range 18 - 93 months). There were no major complications. Group with successful tuberosity repair showed improvement in mean active range of movements, like anterior elevation (165.1° ± 4.9° vs. 144.6° ± 9.4°, p < 0.000), lateral elevation (158.9° ± 7.2° vs. 138.4° ± 9.6°, p < 0.000), external rotation (30.5° ± 6.9° vs. 35.0° ± 6.3°, p = 0.367), internal rotation (33.7° ± 7.5° vs. 32.6° ± 6.9°, p = 0.671) and in mean shoulder scores including Constant score (70.7 ± 4.1 vs. 55.5 ± 5.7, p < 0.000), American shoulder and elbow surgeons score (90.3 ± 2.4 vs. 69.0 ± 5.7, p < 0.000), disability of arm shoulder and hand score (22.1 ± 2.3 vs. 37.6 ± 2.6, p < 0.000).@*CONCLUSION@#Successful repair and tuberosity healing around the RSA prosthesis is associated with statistically significant improvement in postoperative range of motion, strength and shoulder scores. Standardized repair technique and interposition of cancellous bone grafts, harvested from the humeral head can improve the rate of tuberosity healing.


Subject(s)
Humans , Aged , Child, Preschool , Child , Arthroplasty, Replacement, Shoulder/methods , Arm/surgery , Retrospective Studies , Shoulder Fractures/surgery , Humerus/surgery , Humeral Head/surgery , Humeral Fractures/surgery , Treatment Outcome , Range of Motion, Articular
6.
China Journal of Orthopaedics and Traumatology ; (12): 181-184, 2023.
Article in Chinese | WPRIM | ID: wpr-970843

ABSTRACT

OBJECTIVE@#To investigate the clinical efficacy of picture archiving and communication system (PACS) and Photoshop assisted isosceles triangle osteotomy and Kirschner wire fixation with tension band in the treatment of cubitus varus in children.@*METHODS@#The clinic data of 20 children with cubitus varus treated with isosceles triangle osteotomy of distal humerus and Kirschner wire fixation with tension band from October 2014 to October 2019, were retrospectively analyzed. There were 13 males and 7 females, aged from 3.2 to 13.5 years old, the median age was 6.65 years old. PACS system was applied for the osteotomy design preoperatively, simulating and measuring the side length of isosceles triangle osteotomy. Then, Photoshop system was used to simulate the preoperative and postoperative osteotomy graphics, which could guide precise osteotomy during operation.@*RESULTS@#All the 20 patients were followed up for 20 to 24 months, with a median of 22.5 months. At the last follow-up, the carrying angle of the affected limb was 5 ° to 13 °, with a median of 8.3 °. The clinical efficacy was evaluated according to the Flynn elbow function score:excellent in 16 cases, good in 2 cases, and fair in 2 cases.@*CONCLUSION@#The treatment of cubitus varus in children by isosceles triangle osteotomy and Kirschner wire fixation with tension band assisted by PACS and Photoshop system has shown good clinical outcome.


Subject(s)
Male , Female , Humans , Child , Child, Preschool , Adolescent , Humeral Fractures/surgery , Bone Wires , Retrospective Studies , Humerus/surgery , Treatment Outcome , Elbow Joint/surgery , Osteotomy , Joint Deformities, Acquired/surgery , Range of Motion, Articular
7.
China Journal of Orthopaedics and Traumatology ; (12): 156-160, 2023.
Article in Chinese | WPRIM | ID: wpr-970838

ABSTRACT

OBJECTIVE@#To retrospectively analyze the clinical efficacy of olecranon osteotomy approach in the treatment of Dubberley type Ⅲ coronal fractures of the distal humerus and summarize the treatment experience.@*METHODS@#From January 2016 to June 2020, 17 patients (5 males and 12 females) with Dubberley type Ⅲ coronal fractures of the distal humerus were treated by olecranon osteotomy approach. The age ranged from 37 to78 years old with an average of (58.5±12.9) years old. According to Dubberley classification, there were 5 cases of type Ⅲ A and 12 cases of type Ⅲ B. The curative effect was evaluated using the Borberg-Morrey elbow function score. The flexion, extension and rotation range of motion of the elbow joint, complications and postoperative imaging evaluation were recorded.@*RESULTS@#All the 17 patients got bony union. The follow-up time ranged from 12 to 33 months with an average of (15.6±5.6) months. There was 1 case of ischemic necrosis of capitulum humeri, 2 cases of traumatic arthritis and 1 case of heterotopic ossification, 1 case of malunion of fracture. The range of motion was (114.80±19.50) °. The Broberg-Morrey score was 85.3±8.2, excellent in 5 cases, good in 9 cases, fair in 3 cases and poor in 0 case.@*CONCLUSION@#Through olecranon osteotomy approach, the articular surface of distal humerus could be fully exposed, and the operation is convenient. Anatomical reduction and rigid fixation of the articular surface of distal humerus are the key factors for the succesful outcome.


Subject(s)
Male , Female , Humans , Adult , Olecranon Process/surgery , Elbow Joint/surgery , Humeral Fractures/surgery , Retrospective Studies , Fracture Fixation, Internal/methods , Humerus/surgery , Treatment Outcome , Range of Motion, Articular
8.
China Journal of Orthopaedics and Traumatology ; (12): 103-109, 2023.
Article in Chinese | WPRIM | ID: wpr-970828

ABSTRACT

OBJECTIVE@#To explore the clinical outcomes of anteromedial combined with lateral locking plate for complex proximal humeral fractures in the eldery.@*METHODS@#From June 2018 to October 2020, 30 patients who underwent surgical treatment for Neer grade 3 to 4 proximal humeral fractures, including 8 males and 22 females, aged from 51 to 78 years old with an average of (61.5±7.5) years old. Of them, 15 patients had fractures fixed with anteromedial combined with lateral locking plate(ALLP group), whereas 15 received internal fixation with proximal humerus locking plate only(PHLP group). The clinical data, simple shoulder test (SST), humeral head height loss, varus angle and shoulder range of motion were compared between the two groups.@*RESULTS@#All fractures were healed. The follow-up time ranged from 12 to 24 months, with an average of(14.3±2.9) months. The operation time of ALLP group was longer than that of PHLP group (P<0.05). There was no significant difference in intraoperative blood loss between the two groups (P>0.05). There was no significant difference in SST score between the two groups at 1, 3 and 12 months after operation (P>0.05). In terms of radiographic measurement, there was no significant difference in humeral head height loss and varus angle between the two groups at 1 and 3 months after operation (P>0.05). At 12 months after operation, the height loss and varus angle of humeral head in ALLP group were lower than those in PHLP group (P<0.05). In shoulder range of motion, the range of forward elevation in ALLP group was larger than that in PHLP group 1 year after operation(P<0.05). There was no significant difference in external rotation between the two groups.@*CONCLUSION@#Anteromedial combined with lateral locking plate in the treatment of complex proximal humeral fractures in the elderly can increase the stability of the medial column and obtain a good fracture prognosis. But there are also disadvantages such as longer operation time, so it should be individualized according to the fracture type of the patient.


Subject(s)
Male , Female , Humans , Aged , Middle Aged , Treatment Outcome , Shoulder Fractures/surgery , Fracture Fixation, Internal , Shoulder , Humeral Head , Bone Plates , Humeral Fractures/surgery
9.
Article in Spanish | LILACS, BINACIS | ID: biblio-1444932

ABSTRACT

Las fracturas bifocales de húmero son lesiones infrecuentes, más aun las que ocurren asociadas con fracturas en el húmero proximal y diáfisis. Presentamos a cuatro pacientes con fracturas bifocales de húmero proximal y diafisario (Maresca A2), la planificación quirúrgica, los detalles técnicos y sus resultados funcionales. Nivel de Evidencia: IV


Bifocal humeral fractures are infrequent injuries, and fractures involving the proximal and diaphyseal humerus are even rarer. We present four patients with bifocal humeral fractures of the Maresca type A2 classification. We detail the surgical plan, technical pearls, and functional outcomes. Level of Evidence: IV


Subject(s)
Aged , Aged, 80 and over , Shoulder Fractures/surgery , Treatment Outcome , Humeral Fractures/surgery
10.
Chinese Journal of Traumatology ; (6): 256-260, 2023.
Article in English | WPRIM | ID: wpr-1009493

ABSTRACT

PURPOSE@#Intramedullary interlocking nailing is one of the accepted methods of treating humerus diaphyseal fractures. Appropriate nail length and diameter are of paramount importance to achieve a stable fracture fixation. Estimating the nail length can be as challenging in certain cases as it is important. This study aims to provide an easy-to-use formula utilizing clinical measurements from contra lateral arm to accurately estimate humeral nail length.@*METHODS@#This descriptive cross-sectional study was conducted at 3 tertiary care hospitals in Mangalore, India. Patients above the age of 18 years coming to the outpatient department with elbow, shoulder or arm complaints requiring radiological investigation from July 2021 to July 2022 were included. Patients with fractures or dislocations of upper limbs, malunited or non-united fractures of upper limbs, congenital or developmental deformities and patients with open growth plates were excluded. Patients' variables (like age and gender), radiological humerus length and contralateral arm clinical measurements were recorded. An independent samples t-test was used for univariate analysis, and linear regression analysis was done to estimate the desired nail length using the clinical measurement of the humerus (cm) in both genders separately. The significance level was set at p < 0.05.@*RESULTS@#Our study included 204 participants of which 108 were male and 96 were female. The formula for predicting humeral nail length in males is (-2.029) + (0.883 × clinical measurement). The formula for females is 1.862 + (0.741 × clinical measurement). A simplified formula to determine humeral nail length is 0.9 clinical length - 2 cm (in males) and 0.7 × clinical length + 2 cm (in females).@*CONCLUSION@#To improve the stability of fixation with intramedullary nails it is imperative to select the appropriate nail length. There have been studies that devised reliable methods of determining nail lengths in the tibia and femur using preoperative clinical measurements. A similar clinical method of determining humeral nail length is lacking in the literature. Our study was able to correlate radiological lengths of the humerus medullary canal with clinical measurements performed using anatomical landmarks to arrive at a formula. This allows for a reliable and easy nail length determination preoperatively.


Subject(s)
Humans , Male , Female , Adolescent , Cross-Sectional Studies , Bone Nails , Humerus/surgery , Fracture Fixation, Intramedullary/methods , Humeral Fractures/surgery , Treatment Outcome
11.
Chinese Journal of Reparative and Reconstructive Surgery ; (12): 1220-1224, 2023.
Article in Chinese | WPRIM | ID: wpr-1009048

ABSTRACT

OBJECTIVE@#To investigate the effectiveness of medial and lateral column periosteal hinge reconstruction using Kirschner wire in the closed reduction of multi-directional unstable humeral supracondylar fractures in children.@*METHODS@#A clinical data of 43 children with multi-direction unstable humeral supracondylar fractures, who met the selection criteria and were admitted between August 2020 and August 2022, was retrospectively analyzed. Twenty-one cases of fractures were treated wuth closed reduction after medial and lateral column periosteal hinge reconstruction using Kirschner wire and percutaneous Kirschner wires fixation (study group), while 22 cases of fractures were treated by traditional closed reduction technique and percutaneous Kirschner wire fixation (control group). There was no significant difference in gender, age, cause of injury, fracture side, and interval from injury to operation between the two groups ( P>0.05). The operation time, intraoperative fluoroscopy times, the number of children who were changed to open reduction after closed reduction failure, fracture healing time, complications within 2 months after operation, and the Flynn score of elbow joint function at last follow-up were compared between the two groups.@*RESULTS@#All the fractures in the study group were successfully closed reduction, and 4 cases in the control group were changed to open reduction and completed the operation, the difference between the two groups was significant ( P=0.040). The operation time and intraoperative fluoroscopy times of the study group were significantly less than those of the control group ( P<0.05). All children in both groups were followed up 6-18 months with an average of 9.0 months in the study group and 9.8 months in the control group. Imaging review showed that the fractures of both groups healed, and the difference in the healing time between the two groups was not significant ( P=0.373). According to Flynn score at last follow-up, the excellent and good rate of elbow joint function was 95.2% (20/21) in the study group and 86.4% (19/22) in the control group, with no significant difference ( P=0.317). There was no complication such as infection or irritation at the end of Kirchner wire within 2 months after operation.@*CONCLUSION@#For children with multi-directional unstable humeral supracondylar fractures, the use of Kirschner wires to reconstruct the medial and lateral column periosteal hinge to assist in closed reduction has the advantages of shortening operation time, reducing intraoperative fluoroscopy times, and effectively reducing the incidence of open reduction, and can achieve similar postoperative elbow joint function when compared with traditional closed reduction technique.


Subject(s)
Humans , Child , Bone Wires , Retrospective Studies , Fracture Fixation, Internal/methods , Humeral Fractures/surgery , Humerus/surgery , Treatment Outcome
12.
Chinese Journal of Reparative and Reconstructive Surgery ; (12): 1214-1219, 2023.
Article in Chinese | WPRIM | ID: wpr-1009047

ABSTRACT

OBJECTIVE@#To explore the feasibility and early effectiveness of computer-simulated osteotomy based on the health-side combined with guide plate technique in the treatment of cubitus varus deformity in adolescents.@*METHODS@#The clinical data of 23 patients with cubitus varus deformity who met the selection criteria between June 2019 and February 2023 were retrospectively analyzed. There were 17 males and 6 females, ranging in age from 4 to 16 years with an average of 8.5 years. The time from injury to operation was 1-4 years. The angle of distal humerus rotation was defined by humeral head posterior inclination angle using low radiation dose CT to scan the patient's upper extremity data at one time, and the preoperative rotation of the distal humerus on the affected side was (33.82±4.39)°. The CT plain scan data were imported into 9yuan3D digital orthopaedic system (V3.34 software) to reconstruct three-dimensional images of both upper extremities. The simulated operation was performed with the healthy upper extremity as the reference, the best osteotomy scheme was planned, overlapped and compared, and the osteotomy guide plate was prepared. The patients were followed up regularly after operation, and the formation of callus in the osteotomy area was observed by X-ray examination. Before and after operation, the carrying angle of both upper extremities (the angle of cubitus valgus was positive, and the angle of cubitus varus was negative) and anteversion angle were measured on X-ray and CT images. At the same time, the flexion and extension range of motion of elbow joint and the external rotation range of motion of upper extremity were measured, and Mayo score was used to evaluate the function of elbow joint.@*RESULTS@#The operation time ranged from 34 to 46 minutes, with an average of 39 minutes. All patients were followed up 5-26 months, with a mean of 14.9 months. All the incisions healed by first intention after the operation; 2 patients had nail path irritation symptoms after Kirschner wire fixation, which improved after dressing change; no complication such as breakage and loosening of internal fixators occurred after regular X-ray review. Continuous callus formed at the osteotomy end at 4 weeks after operation, and the osteotomy end healed at 8-12 weeks after operation. At last follow-up, the carrying angle, anteversion angle, external rotation range of motion, and extension and flexion range of motion of the elbow joint of the affected side significantly improved when compared with preoperative ones ( P<0.05). Except for the extension range of motion of the healthy elbow joint ( P<0.05), there was no significant difference in other indicators between the two sides ( P>0.05). At last follow-up, the Mayo elbow score was 85-100, with an average of 99.3; 22 cases were excellent, 1 case was good, and the excellent and good rate was 100%.@*CONCLUSION@#Computer-simulated osteotomy based on health-side combined with guide plate technique for treating cubitus varus deformity in adolescents can achieve precise osteotomy, which has the advantages of short operation time and easy operation, and the short-term effectiveness is satisfactory.


Subject(s)
Male , Female , Humans , Adolescent , Child, Preschool , Child , Elbow , Humeral Fractures/surgery , Retrospective Studies , Joint Deformities, Acquired/surgery , Elbow Joint/surgery , Limb Deformities, Congenital , Osteotomy/methods , Humeral Head , Range of Motion, Articular , Computers , Treatment Outcome
13.
Chinese Journal of Reparative and Reconstructive Surgery ; (12): 952-957, 2023.
Article in Chinese | WPRIM | ID: wpr-1009007

ABSTRACT

OBJECTIVE@#To compare the effectiveness of ultrasound- and arthrography-assisted Kirschner wire fixation in the treatment of Jakob type Ⅱ lateral condylar humerus fracture (LCHF) in children.@*METHODS@#A clinical data of 101 children with Jakob type Ⅱ LCHF, who met the selection criteria and were admitted between April 2021 and April 2022, was retrospectively analyzed. Of them, 47 cases were treated with ultrasound-assisted Kirschner wire fixation (group A), and 54 cases with arthrography-assisted surgery (group B). There was no significant difference in gender, age, cause of injury, fracture side, and disease duration between groups (P>0.05). Intraoperative fluoroscopy times, operation time, and hospital stay, Flynn elbow joint function score, and postoperative complications were recorded and compared between groups. X-ray examination was performed to observe the healing of fracture, and measure the carrying angle and the shaft-condylar angle (SCA).@*RESULTS@#The success rate of closed reduction was significantly higher in group A than in group B (P<0.05), and the intraoperative fluoroscopy times was significantly less in group A than in group B (P<0.05). There was no significant difference in operation time and hospital stay between groups (P>0.05). All children in both groups were followed up 12-18 months, with an average of 13.6 months. X-ray reexamination showed that the fractures of both groups healed, and the difference in healing time was not significant (P>0.05). At last follow-up, there was no significant difference in carrying angle and SCA between unaffected side and affected side in both groups and between groups A and B in affected side (P>0.05). There was no significant difference in Flynn elbow joint function score between groups (P>0.05). There were 18 cases of lateral spurs formation in group A, 1 case of pinning infection and 26 cases of lateral spurs formation in group B, and there was no significant difference in the incidence of the above complications (P>0.05).@*CONCLUSION@#Compared with the arthrography, the ultrasound-assisted Kirschner wire fixation in the treatment of Jakob type Ⅱ LCHF in children can avoid the open reduction and decrease the number of intraoperative fluoroscopy, and obtain the good effectiveness.


Subject(s)
Child , Humans , Male , Female , Arthrography , Bone Wires , Humeral Fractures/surgery , Humerus , Retrospective Studies
14.
Rev. bras. ortop ; 57(2): 301-307, Mar.-Apr. 2022. tab, graf
Article in English | LILACS | ID: biblio-1387982

ABSTRACT

Abstract Objective To choose an appropriate posterior approach for distal humerus fractures in adults. Methods Fifty patients with distal humerus fractures were analyzed prospectively. The fractures were classified using the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO, Working Group for Bone Fusion Issues, in German/OTA) classification. The patients were divided into group A and group B. Olecranon osteotomy (the transolecranon approach) was performed in 30 patients, and the triceps-reflecting approach was used in 20 patients. The functional results were evaluated using the Mayo Elbow Performance Score (MEPS) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Results The average operative time was of 92.62 8.73 minutes for group A, and of 78.63 7.02 minutes for group B, (p< 0.01), and the average blood loss was of 222.78 34.93 mL for group A, and of 121.61 19.85 mL for group B, (p< 0.01), which were statistically significant. The mean scores on the MEPS and DASH of both groups were found to be insignificant. Complications like infection, neurapraxia and soft tissue irritation where observed more in group A. Conclusion The triceps-reflecting approach results in a shorter operative time, a lower levels of blood loss, and a low rate of complications, and olecranon osteotomy provides better accuracy in terms of articular reduction. But there were no significant differences between the two groups regarding the functional outcome. Therefore, we have proposed a new classification that is a modification of the AO/OTA classification: type 1 includes AO grades 13A to C2 (B3 excluded); and type 2, AO 13C3. For type-1 fractures, the triceps-reflecting approach may be considered, and, for type-2 fractures, olecranon osteotomy.


Resumo Objetivo Escolher uma abordagem posterior adequada para fraturas distais do úmero em adultos. Métodos Cinquenta pacientes com fraturas distais do úmero foram analisados prospectivamente. As fraturas foram classificadas por meio da classificação Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA). Os pacientes foram divididos em grupo A e grupo B. A osteotomia olecraniana (abordagem transolecraniana) foi realizada em 30 pacientes, e a abordagem por reflexão do tríceps foi usada em 20 pacientes. Os resultados funcionais foram avaliados por meio do Mayo Elbow Performance Score (MEPS) e do questionário Disabilities of the Arm, Shoulder and Hand (DASH). Resultados O tempo médio da cirurgia foi de 92,62 8,73 minutos para o grupo A, e de 78,63 7,02 minutos para o grupo B (p< 0,01) e a média da perda sanguínea foi de 222,78 34,93 mL no grupo A, e de 121,61 19,85 mL no grupo B (p< 0,01), os quais foram estatisticamente significativos. As pontuações médias no MEPS e no DASH de ambos os grupos foram consideradas insignificantes. Complicações como infecção, neurapraxia e irritação de tecidos moles foram mais observadas no grupo A. Conclusão A abordagem por reflexão do tríceps resulta em menor tempo de operação, menor perda de sangue, e baixas taxas de complicações, e a osteotomia olecraniana proporciona uma melhor precisão da redução articular. Mas não houve diferença significativa entre os dois grupos em termos do resultado funcional. Por isso, propusemos uma nova classificação, que é uma modificação da classificação AO/OTA: o tipo 1 inclui os graus AO 13A a C2 (excluído o B3); e o tipo 2, AO 13C3. Para fraturas do tipo 1, a abordagem por reflexão do tríceps pode ser considerada, e, para as fraturas do tipo 2, a osteotomia olecraniana.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Osteotomy , Olecranon Process , Humeral Fractures/surgery , Prospective Studies , Surveys and Questionnaires
15.
China Journal of Orthopaedics and Traumatology ; (12): 1142-1147, 2022.
Article in Chinese | WPRIM | ID: wpr-970798

ABSTRACT

OBJECTIVE@#To explore clinical effect of double plate technique in treating Neer 3 to 4 partial fractures of proximal humerus.@*METHODS@#From May 2018 to December 2020, 38 patients with proximal humeral classified to Neer 3 to 4 partial fractures were treated with double plate technique and long head tendon fixation of biceps brachii, including 23 males and 15 females, aged from 41 to 89 years old with an average of (67.00 ± 9.76) years old;23 patients classified to Neer 3 fracture, 15 classified to Neer 4 fracture;the time from injury to operation ranged from 5 to 12 days with an average of (8.00±2.86) days. Degree of pain was evaluated by numerical rating scale(NRS) on the third day after operation; change of height of humeral head and angle of humeral neck stem were measured and compared between 2 days and 1 year after operation. Neer score was used to evaluate recovery of shoulder joint after operation at 1 year after operation.@*RESULTS@#All 38 patients were followed up for 12 to 19 months with an average of (14.00±1.59) months. NRS score at 3 days after operation was (1.95±0.73) points. Fracture healing time ranged from 2.2 to 3.2 months with an average of(2.60±0.27) months. There were no significant difference in the height of humeral head and angle of humeral neck trunk between two days and 1 year after operation(P>0.05). Four Neer 4 fracture patients occurred absorption of greater tubercle of humerus and partial cystic change of humeral head, but the activity function of shoulder joint was good. Postoperative Neer score at 1 year was 89.50±5.19, and 20 patients got excellent results, 16 good, and 2 moderate.@*CONCLUSION@#Double plate technique and long head tendon fixation of biceps brachii were used to treat Neer 3 to 4 fractures of proximal humerus has good clinical effect, and postoperative pain was mild, without special instruments.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Bone Plates , Fracture Fixation, Internal/methods , Humeral Head , Humerus , Pain, Postoperative , Shoulder Fractures/surgery , Tendons , Treatment Outcome , Humeral Fractures/surgery
16.
Chinese Journal of Traumatology ; (6): 145-150, 2022.
Article in English | WPRIM | ID: wpr-928488

ABSTRACT

PURPOSE@#The purpose of this study was to assess and compare elbow range of motion, triceps extension strength and functional results of type C (AO/OTA) distal humerus fractures treated with bilateral triceps tendon (BTT) approach and olecranon osteotomy (OO). At the same time, we are also trying to know whether BTT approach can provide sufficient vision for comminuted intra-articular fractures of the distal humerus, and whether it is convenient to convert to the treatment to total elbow arthroplasty (TEA) or OO.@*METHODS@#Patients treated with OO and BTT approaches for type C distal humerus fractures between July 2014 and December 2017 were retrospectively reviewed. Inclusion criteria include: (1) patients' age were more than 18 years old, (2) follow-up was no less than 6 months, and (3) patients were diagnosed with type C fractures (based on the AO/OTA classification). Exclusion criteria include: (1) open fractures (Gustillo type 2 or type 3), (2) treated by other approaches, and (3) presented with combined injuries of ipsilateral upper extremities, such as ulnar nerve. Elbow range of motion and triceps extension strength testing were completely valuated, when the fractures had healed. Assessment of functional results using the Mayo elbow performance score and complications were conducted in final follow-up. The data were compared using the two tailed Student's t-test. All data were presented as mean ± standard deviation.@*RESULTS@#Eighty-six patients of type C distal humerus fractures, treated by OO and BTT approach were retrospectively reviewed between July 2014 and December 2017. Fifty-five distal humerus fractures (23 males and 32 females, mean age 52.7 years) treated by BTT approach or OO were included in this study. There were 10 fractures of type C1, 16 type C2 and 29 type C3 according to the AO/OTA classification. Patients were divided into two surgical approach groups chosen by the operators: BTT group (28 patients) and OO group (27 patients). And the mean follow-up time of all patients was 15.6 months (range, 6-36 months). Three cases in BTT group were converted to TEA, and one converted to OO. Only one case in BTT group presented poor articular reduction with a step more than 2 mm. There were not significantly different in functional outcomes according to the Mayo elbow performance score, operation time and extension flexion motion are values between BTT group and OO group (p > 0.05). Complications and reoperation rate were also similar in the two groups. Triceps manual muscle testing were no significant difference in the two groups, even subdivided in elder patients (aged >60 years old).@*CONCLUSION@#BTT is a safe approach to achieve similar functional result comparing with OO. BTT were not suitable for every case with severe comminuted pattern, but it avoids the potential complications related to OO, and has no complications concerning with triceps tendon. It is convenient for open reduction internal fixation and flexible to be converted to OO, as well as available to be converted to TEA in elder patients.


Subject(s)
Adolescent , Aged , Female , Humans , Infant , Male , Middle Aged , Elbow Joint/injuries , Fracture Fixation, Internal/methods , Fractures, Comminuted , Humeral Fractures/surgery , Humerus , Range of Motion, Articular , Retrospective Studies , Tendons , Treatment Outcome
17.
Article in Spanish | LILACS, BINACIS | ID: biblio-1392485

ABSTRACT

Objetivo: Describir los resultados obtenidos en el tratamiento de las fracturas de húmero distal mediante reducción abierta y fijación interna y reflejar si el abordaje empleado tuvo impacto en el resultado funcional. Materiales y métodos: Se llevó a cabo un estudio retrospectivo de presentación de casos. Se evaluó a 19 pacientes con diagnóstico de fractura de húmero distal compleja tratados con reducción abierta y fijación interna entre 2015 y 2021. Se realizó un control radiográfico periódico y se evaluó el resultado funcional mediante escalas internacionales, como DASH y MEPS. Luego se procedió a extrapolar las variables obtenidas utilizando un programa estadístico. Resultados: Se logró la consolidación de todas las fracturas. Se empleó el abordaje de Alonso Llames en 7 pacientes (37%) y la osteotomía de olécranon en 12 casos (63%). El puntaje DASH promedio fue de 11,31, lo que determinó discapacidades leves. El puntaje MEPS obtenido fue excelente en un paciente (5,26%), bueno en 10 (52,6%), regular en 7 (36,84%) y pobre en 1 (5,26%). Conclusiones: La reducción abierta y la fijación interna son eficaces para tratar las fracturas complejas de húmero distal, permiten lograr buenos resultados posquirúrgicos. En esta serie, el 57% de los pacientes obtuvo resultados excelentes o buenos. No se halló una diferencia estadísticamente significativa con respecto a la elección de un abordaje u otro. Nivel de Evidencia: IV


Objective: To describe the results obtained in the treatment of distal humerus fractures by open reduction and internal fixation (ORIF) and to reflect whether the approach used had an impact on the functional outcome. Materials and methods: We carried out a retrospective case study of 19 patients with a diagnosis of complex distal humerus fracture who were treated with ORIF from 2015 to 2021. Periodic radiographic controls were performed and the functional outcome was evaluated using internationally known scales such as the DASH and Mayo Elbow performance Score (MEPS), then the variables obtained were extrapolated using statistical software. Results: A 100% consolidation rate was achieved; in 7 patients (37%), the Alonso Llames approach was used and in 12 cases (63%), we performed an olecranon osteotomy. The average DASH was 11.31, which determined mild disabilities. The MEPS obtained was excellent in 1 patient (5.26%), good in 10 (52,6%), fair in 7 (36.84%), and poor in 1(5.26%). When comparing the results obtained through the different approaches a P = 0.4197 was obtained in the ANOVA test and P =0.4723 in the Mann-Whitney/Wilcoxon Two sample Test. Conclusions: We conclude that ORIF is effective in the treatment of complex fractures of the distal humerus, allowing the surgeon to obtain good post-surgical results. In this series, the average DASH was 11.31, with excellent and good results in 57% of the patients. We found no statistically significant difference regarding the choice of one approach or the other. Level of Evidence: IV


Subject(s)
Adult , Middle Aged , Osteotomy , Elbow Joint/injuries , Olecranon Process , Fracture Fixation, Internal , Humeral Fractures/surgery
18.
Arq. bras. med. vet. zootec. (Online) ; 73(3): 647-652, May-June 2021. ilus
Article in English | LILACS, VETINDEX | ID: biblio-1278370

ABSTRACT

The treatment of fractures from the thoracic limb in giant anteaters is extremely challenging. Unfamiliar and peculiar anatomical characteristics, robust musculature and the imminent need for an early return to limb function highlight such challenges. The objective of this report was to describe the successful use of anatomical osteosynthesis with a robust locking compression plate in a humeral fracture of an adult giant anteater. The patient was rescued on the highway after being run over and presented for treatment at the Veterinary Teaching Hospital. Surgical stabilization was performed using a craniomedial approach to the humerus, using a customized broad 3.5mm locking compression plate. The patient presented early limb support at 24 hours postoperatively. Radiographic monitoring was performed at 30, 60 and 90 days postoperatively, and bone healing was observed without any complications. It is concluded that the treatment of humerus fractures in giant anteaters requires robust fixation. The use of a reinforced locking compression plate system proved to be effective and adequate to the mechanical load that an adult individual of this species needs for early use of the thoracic limb and, at the same time, efficient in controlling interfragmentary movement, which allowed fracture consolidation.(AU)


O tratamento das fraturas do membro torácico dos tamanduás-bandeira (Myrmecophaga tridactyla) é extremamente desafiador. Características anatômicas pouco familiares e peculiares, musculatura muito desenvolvida e necessidade iminente de retorno precoce à função do membro destacam tais desafios. Objetivou-se, neste relato, descrever a utilização com sucesso da osteossíntese anatômica com placa bloqueada robusta em fratura umeral de um tamanduá-bandeira. O paciente foi resgatado em rodovia após atropelamento e atendido no Hospital Veterinário Universitário. Após sedação e avaliação física completa, foi realizado exame radiográfico, o qual revelou fratura completa oblíqua curta em diáfise média de úmero esquerdo. A estabilização cirúrgica foi realizada por abordagem craniomedial ao úmero, utilizando-se placa bloqueada (LCP) do sistema 3,5mm customizada. O paciente apresentou apoio precoce do membro com 24 horas de pós-operatório. Realizou-se acompanhamento radiográfico aos 30, 60 e 90 dias, sendo observada união clínica sem quaisquer complicações. Conclui-se que o tratamento das fraturas do úmero em tamanduás-bandeira exige robustez na fixação. A utilização de sistema reforçado de placa bloqueada mostrou-se efetiva e adequada à carga mecânica de que um indivíduo adulto dessa espécie necessita para uso precoce do membro torácico e, ao mesmo tempo, eficiente no controle da movimentação interfragmentária, o qual permitiu consolidação da fratura.(AU)


Subject(s)
Animals , Fracture Healing , Eutheria/surgery , Fracture Fixation, Internal/methods , Fracture Fixation, Internal/veterinary , Humeral Fractures/surgery , Humeral Fractures/veterinary , Bone Plates/veterinary , Animals, Wild/surgery
19.
China Journal of Orthopaedics and Traumatology ; (12): 856-860, 2021.
Article in Chinese | WPRIM | ID: wpr-921905

ABSTRACT

OBJECTIVE@#To investigate clinical effects of intraoperative arthrography monitoring assisted closed reduction and internal fixation for intercondylar fracture of humerus in children.@*METHODS@#From January 2013 to July 2018, 18 children with intercondylar fracture of humerus were treated by operation, including 13 males and 5 females aged from 3 to 12 years old with an average age of (8.50±2.57) years old. According to Toniolo & Wilkinson classification, 8 children were typeⅠand 10 children were typeⅡ. During the operation, closed reduction and internal fixation were performed under the monitoring of intraoperative radiography, open reduction and internal fixation were performed in necessity. Mayo score of elbow joint was used to evaluate clinical effect at 6 months after operation.@*RESULTS@#All children were underwent arthrography monitoring during operation, 5 children were treated with closed reduction and internal fixation for intraoperative arthrography found no fracture of articular cartilage, 11 children by closed reduction and internal fixation because of fracture of articular cartilage involving the joint space with displacement less than 2 mm, and 2 children by closed or open reduction and internal fixation for fracture of articular cartilage surface with displacement above 2 mm, which 1 child with smooth of joint surface was performed closed reduction and internal fixation, 1 child without smooth of joint surface and displacement above 2 mm was performed open reduction and internal fixation. All children were followed up from 8 to 26 months with an average of (20.28±4.40) months. All factures were healed from 6 to 9 weeks with an average of (7.33±0.77) weeks. Postoperative Mayo score of elbowjoint at 6 months was (89.44±11.36), and 12 patients got excellent results, 5 good and 1 poor. One patient occurred partial limitation of flexion or extension of elbow joint. No elbow deformity and other complications occurred.@*CONCLUSION@#The treatment of intercondylar fracture of humerus in children under monitoring of intraoperative radiography could reduce opertaion injuries and complications, confirm the reduction effect of articular surface of cartilage in time and clearly, and promote recovery of elbow joint function.


Subject(s)
Child , Child, Preschool , Female , Humans , Male , Arthrography , Fracture Fixation, Internal , Humeral Fractures/surgery , Humerus , Treatment Outcome
20.
China Journal of Orthopaedics and Traumatology ; (12): 437-441, 2021.
Article in Chinese | WPRIM | ID: wpr-879458

ABSTRACT

OBJECTIVE@#To explore clinical effectiveness and safety of ultrasound-guided closed reduction and K-wires internal fixation in treating of Kilfoyle Ⅱand Ⅲ medial condylar fracture of humerus in children.@*METHODS@#Clinical data of 32 children with medial condylar fracture of humerus treated with closed reduction and internal fixation with K-wires under the guidance of ultrasound were retrospectively analyzed from January 2014 to August 2019, including 23 males and 9 females, age ranged from 3.2 to 12.8 years old with an average of (8.3±2.1) years old;According to classification of Kilfoyle, 12 patients classified to typeⅡ and 20 patients were type Ⅲ;5 patients combined with elbow dislocation;the time from injury to operation ranged from 1 to 5 days with an average of (3.1±1.3) days. Radiological evaluation of treatment results and complications were observed. At the final follow up, Mayo elbow performance score(MEPS) was used to evaluate elbow function. And humerus-ulna angle on the affect side and healthy side were measured and compared.@*RESULTS@#All patients were followed up from 8 to 26 months with an average of(19.3±5.5) months. All fractures were healed well, the healing time ranged from 4 to 6 weeks with an average of (4.5±0.5) weeks. No infection, vascular and nerve injury, bone nonunion, trochlear necrosis, cubitus varus or valgus deformity were occurred. According to Mayo scoring, all patients were assessed as excellent. There was no significant difference in angle of humerus-ulna between affectedside (9.5±3.6)° and healthy side (9.1±3.5)°, and no difference in MEPS scores between affected side(95.3±2.5) and healthy side(96.3±2.2)(@*CONCLUSION@#For Kilfoyle typeⅡand Ⅲ medial condylar fracture of humerus in children, closed reduction and internal fixation with K-wire under ultrasound guidance is a safe and effective method, and could promote in further.


Subject(s)
Child , Child, Preschool , Female , Humans , Male , Bone Wires , Fracture Fixation, Internal , Humeral Fractures/surgery , Humerus , Retrospective Studies , Treatment Outcome , Ultrasonography, Interventional
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